Vol. 8, Issue 3 (2019)

Materials and methods: During 2000-2018, 170 patients with a low neck phlegmon were examined and treated in 170 patients with thoracic surgery in the Ivano-Frankivsk Regional Clinical Hospital, of which 97 (57.1%) without penetration of purulent infection in the mediastinum, in 73 (42.9%) neck phlegmon was complicated by the development of the purulent descending mediastinitis.

Research results: Intramedistinal administration of antibacterial agents was used in 33 (19.4%) patients. Purulent process was eliminated at the stage of neck phlegmon in 30 (90.9%) patients, development of purulent descending mediastinitis were observed in 3 (9.1%) patients. In conducting the through cervical drainage of abscesses of the mediastinum, repeated surgical intervention were used in 15 (50%) patients. When using the video-assisted thoracoscopy, simultaneously with the trans cervical drainage, we managed to reduce the number of repeated surgical intervention from 50% to 11.1%.

1.The primary task in surgical treatment of patients with purulent descending mediastinitis should provide adequate disclosure and drainage of the causes of purulent infection on the neck.

2. The use of intramediastinal administration of antibacterial agents can prevent the spread of purulent infection from interfascial nicks in the mediastinum. By using this technique, we managed to reduce the incidence of infection from 50.7% to 9.1% of cases.

3. The cervical drainage of mediastinal abscesses, was not always ensure the effective elimination of purulent process. The use of additional surgical intervention should be with the slightest signs of the spread of purulent process in lower mediastinum.

4. With the use of video-assisted thoracoscopy, simultaneously with trans cervical drainage, we managed to reduce the number of repeated surgical interventions from 50% to 11.1%